OBJECTIVE: To present three differing clinical etiologies of mitral valve stenosisMETHODS: Brief medical history in addition to echocardiographic and intraoperative images will be used highlight mitral valve stenosis. The etiology of each case includes Rheumatic mitral stenosis with regurgitation, congenital mitral stenosis, and degenerative (calcific) mitral stenosis.RESULTS: All three cases highlight clinical and echocardiographic findings. These can be used to help the clinician determine the etiology of the valvulopathy and identify characteristic anatomic lesions on the valve that lead to the dysfunction. The intra-operative images highlight techniques used to correct the lesions and restore valve function.CONCLUSIONS: Mitral valve stenosis has many differing etiologies. Understanding these can aid the surgeon in choosing appropriate surgical techniques for valve reconstruction or replacement.